Before I started working in health care revenue cycle management, I might have doubted my right to contest this bill. But I now know better, and hope to put others in the same position.
This is a bill for a fifteen minute telehealth session with a DO, a Doctor of Osteopathy. It doesn’t count the $30 co-pay I paid, or the payment for the prescription she wrote. And I’m not contesting the fee, contestable as it may be. What I’m contesting is Capital Health’s right to send me a bill at all, given that… Continue reading →
The wounded woman gets called a stereotype and sometimes she is. But sometimes she’s just true.
–Leslie Jamison, “Grand Unified Theory of Female Pain,” The Empathy Exams*
On the day before New Year’s back in 2021, I found myself riding the train to work when, one stop after mine, a vaguely familiar woman got on. Or maybe I should say, struggled on. She was, I guess, in her sixties, heavy-set, apparently in pain, though not from any obvious cause, and was struggling with a shopping cart full of possessions. At first, in a reflexive reaction to the shopping cart, I took her to be a homeless person, but that turned out not to be the case. She clearly had trouble moving, and had trouble getting the cart onto the train. I half got up to help her, but not knowing how my gallantry would be received, sat back down and watched her struggle. It was rush hour, just before 8 am. Continue reading →
No one was particularly impressed a year ago when I predicted on Facebook that if we got involved in Ukraine, we could expect Russian hackers to attack American medical facilities, with worrisome consequences. Big deal, I was told. Ukraine must be defended, and if so, such costs must be discounted.
Christopher Hitchens tells the possibly (probably) apocryphal story of Robert Conquest, the historian: after writing a first book on the brutalities of Soviet socialism, The Great Terror: Stalin’s Purges of the 1930s, Conquest submitted a second as-yet untitled manuscript on Stalin’s program of forced collectivization. Asked what he wanted to call it, he came up with the ungracious and yet apt title, I Told You So, You Fucking Fools. The book was, in the end, called The Harvest of Sorrow: Soviet Collectivization and the Terror Famine, followed by a third, Stalin: Breaker of Nations.
I lack Robert Conquest’s erudition, productivity, or grace, but I do have one thing in common with him: I told you so, too–not about Stalin, but about “football,” i.e., American football, a bloodsport whose deceptions begin with its name. Continue reading →
In New York University’s busy Manhattan emergency department, Room 20 is special.
Steps away from the hospital’s ambulance bay, the room is outfitted with equipment to perform critical procedures or isolate those with highly infectious diseases.
Doctors say Room 20 is usually reserved for two types of patients: Those whose lives are on the line. And those who are V.I.P.s.
NYU Langone denies putting V.I.P.s first, but 33 medical workers told The New York Times that they had seen such patients receive preferential treatment in Room 20, one of the largest private spaces in the department. One doctor was surprised to find an orthopedic specialist in the room awaiting a senior hospital executive’s mother with hip pain. Another described an older hospital trustee who was taken to Room 20 when he was short of breath after exercising.
The privileged treatment is part of a broader pattern, a Times investigation found. For years, NYU’s emergency room in Manhattan has secretly given priority todonors, trustees, politicians, celebrities, and their friends and family, according to 45 medical workers, internal hospital records and other confidential documents reviewed by The Times.
Not long ago, while applying for hospital-based jobs, it occurred to me that I lacked a certification that I really ought to have, namely, Basic Life Support, or BLS. From the website of the American Red Cross:
Basic Life Support, or BLS, generally refers to the type of care that first-responders, healthcare providers and public safety professionals provide to anyone who is experiencing cardiac arrest, respiratory distress or an obstructed airway. It requires knowledge and skills in cardiopulmonary resuscitation (CPR), using automated external defibrillators (AED) and relieving airway obstructions in patients of every age.
So I signed up for a class in my area, and decided to certify. It was relatively cheap, conveniently located, and scheduled to take all of four hours. A bargain.Continue reading →
The 2002 film “John Q” begins with a scene in which a reckless driver dies, clearly at fault, in a horrific car wreck. Her organs, including her heart, are “harvested” or “recovered,” depending on your preferred choice of medical terminology, for purposes of organ donation. That organ recovery drives the plot of the rest of the film, which involves–somewhat heavy-handedly–the transplant of that very heart into a totally unrelated person dying of heart disease. In short, one person’s recklessness becomes her tragic demise; that tragedy becomes another person’s salvation.
After about a year and a half of working in health care, and at least some casual reading of the relevant literature, I’m increasingly skeptical that a libertarian free market can provide an adequate basis for the provision of health care. The longer I work in the field, the more convinced I become of the essential truth of Kenneth Arrow’s famous insight about the economics of health care:
[T]he special economic problems of medical care can be explained by adaptations to uncertainty in the incidence of disease and in the efficacy of treatment (emphasis added).*
I’ve defended both the idea of cancellation in the abstract, as well as specific cancellations, done in specific ways, on this blog. My critics have done an end-run around what I’ve actually said about cancellation, as well as the examples I’ve adduced, focusing on the unintended consequences of cancellation that lead, or supposedly lead, to “lynch mobs,” the “thought police,” and the like.*
I still have a great deal more to say about cancellation as both a philosophical and a historical matter, but in honor of one of the greatest cancelers in American history, Martin Luther King Jr (whose birthday is celebrated tomorrow), I’ve decided to descend to casuistry and inaugurate Cancel Week: a week of posts devoted to nothing but cancellations and anti-cancellations. (Sotto voce confession: I have a lot more than seven examples at my disposal, so this “week” may last awhile. But if revolutionism entails revisionism, revisionism about the meaning of “week” is to be expected.)
I don’t remember the last time, if ever, that I ran three memorial posts in such close succession, but I wanted to mark the passing of my friend Carol Welsh (b. 1970) on the morning of Wednesday, December 29, 2021. Carol died of complications sustained over a 21-year struggle with a brain tumor, a recurrent ependymoma malignant by location. Continue reading →